Experts criticize bungled German E. coli inquiry

Tuesday

Jun 7, 2011 at 10:29 PM

LONDON - Outside health experts and German lawmakers roundly criticized Germany on Tuesday for a bungled investigation into the world's deadliest E. coli outbreak, saying the infections should have been spotted much sooner.

Many experts have been surprised, even shocked, at lapses in the German inquiry, and some say the culprit food may never be known.

Weeks after the outbreak began on May 2, German officials are still looking for its cause. Spanish cucumbers were initially blamed, then ruled out after tests showed they had a different strain of E. coli. On Sunday, investigators pointed the finger at German sprouts, only to backtrack a day later when initial tests were negative. The sprouts are still being tested.

"If we don't know the likely culprit in a week's time, we may never know the cause," said Dr. Guenael Rodier, the director of communicable diseases at the World Health Organization.

Rodier said the contaminated vegetables have probably disappeared from the market and it will be difficult to link patients to tainted produce weeks after they first became infected.

So far, the super-toxic strain of E. coli has killed 24 people, infected more than 2,400 and left hundreds hospitalized with a serious complication that can lead to kidney failure. New cases are being reported every day - 94 more in Germany on Tuesday.

Other experts were far more critical of the German investigation.

Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota, said officials should have done more detailed patient interviews as soon as the outbreak began to trace cases of illness to infected produce.

Tests on current produce won't be helpful, he said. "It's like looking at camera footage of a traffic intersection today to see what caused an accident three weeks ago."

"If you gave us 200 cases and five days, we should be able to solve this outbreak," added Osterholm, whose team has contained numerous food-borne outbreaks in the United States.

He also disputed the idea that it might be impossible to find the source. "To say we may never solve this is just an excuse for an ongoing bad investigation," he said.

German lawmakers also slammed the government's response to the outbreak, criticizing the confusing announcements and retractions.

Christine Clauss, Saxony's state health minister and a member of Chancellor Angela Merkel's own governing party, said states were initially conducting their own investigations into the outbreak.

"It would be especially important to cooperate more closely and in a more centralized way in situations with a nationwide germ," she told the daily newspaper Leipziger Volkszeitung.

Karl Lauterbach, a doctor who serves as the health expert for the opposition Social Democrats, has repeatedly urged the government to set up a national crisis team to counter the lack of coordination and the leadership vacuum among the federal and state authorities responding to the crisis.

Paul Hunter, a professor of health protection at the University of East Anglia in England, said the outbreak could have been detected sooner if doctors regularly did lab tests on patients with diarrhea - a standard practice in Britain.

"They could miss an outbreak starting until people get quite sick with severe complications," he said.

Hunter said German doctors probably only realized how widespread the infections were when the number of patients with kidney failure spiked in mid-May.

On Tuesday, the EU health chief warned Germany against issuing any more premature - and inaccurate - conclusions about the source of contaminated food.

"It is crucial that national authorities do not rush to give information on the source of infection that is not proven by bacteriological analysis, as this spreads unjustified fears (among) the population all over Europe and creates problems for our food producers," EU health chief John Dalli said.

Tests are continuing on sprouts from an organic farm in northern Germany, but have so far come back negative.

Rodier said that doesn't necessarily exonerate the vegetables.

"Just because tests are negative doesn't mean you can rule them out," he said. "The bacteria could have been in just one batch of contaminated food and by the time you collect specimens from the samples that are left, it could be gone."

Hunter said the outbreak could have devastating consequences for consumers' faith in food safety.

Authorities in Germany "just have not done a good job of explaining why their assessments keep changing and as a result, it may be a long time before many people eat cucumbers and sprouts again," Hunter said.

Still, in outbreaks, it is not unusual for certain foods to be suspected at first, then ruled out.

In 2008 in the U.S., raw tomatoes were initially implicated in a nationwide salmonella outbreak. Consumers shunned tomatoes, costing the tomato industry millions. Weeks later, jalapeno peppers grown in Mexico were determined to be the cause.

In 2006, lab tests mistakenly pointed to green onions in an E. coli outbreak at Taco Bell restaurants in the U.S. Investigators considered cheddar cheese and ground beef as the source before settling on lettuce.

In Europe, a heated battle erupted Tuesday over compensation to farmers blind-sided by plunging demand as a result of the outbreak, with vegetable producers Spain and France scoffing at the amount proposed by the EU farm chief.

Farm Commissioner Dacian Ciolos suggested â‚¬150 million ($219 million) - about 30 percent of the value of vegetables that cannot be sold. The losses to EU farmers have been staggering - in the neighborhood of â‚¬417 million ($611 million) a week.

As of Tuesday, Germany's national disease control center reported 24 deaths - 23 in Germany and one in Sweden - and 2,325 infections in Germany, including 642 patients with a rare complication that may lead to kidney failure. Ten other European countries and the United States have another 100 cases.

The Robert Koch Institute reported a slight decline in the rate of newly reported infections, a sign the epidemic may have reached its peak, but added it was not certain whether that decrease will continue.

Hospitals in northern Germany were still being crushed by the demands of caring for E. coli patients.

A 41-year-old Hamburg lawyer who was hospitalized for more than a week in a separate hospital ward for E. coli cases described a surge in infections.

"When I got there, it wasn't that full yet, but then more patients came every day," she told the Sueddeutsche Zeitung newspaper, speaking on condition of anonymity because she didn't want her family identified.

Now discharged, she remains quarantined at home.

"People here are very, very much afraid," she said.

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